Clinician and simulated patient scoring - the psychometrics of a national programme recruiting dentists to DF1 training posts.

INTRODUCTION: In 2012 a national, standardised approach was taken to UK Dental Foundation 1 recruitment. Prior to that recruitment method was at the discretion of individual Deaneries. The new national system is interactive, including simulated patients to see how applicants perform in a clinical communication context. A question was whether simulated patient scores could/should be awarded as well as clinicians' scores. This paper presents score data collected in the first round of national DF1 recruitment centres, with focus on how clinical examiners and trained simulated patients rated applicants. METHOD: At the live recruitment events across four national centres score data were collected from observing clinical assessors and simulated patients on the communication station. On this occasion only the clinician awarded scores 'counted', but all simulated patients completed marking sheets to enable the process to be evaluated. Data were retrospectively analysed to test the hypotheses that there would be no significant scoring differences between centres and that inter-rater reliability, by applicant, between paired clinicians, and between clinicians and simulated patients would be strong. RESULTS: Results showed encouraging consistency between assessors, with some differences between centres. Clinicians were more likely to offer a borderline score. In communication analyses empathy had the weakest correlation with the overall score, while professional attitude had the strongest correlation. Data supported the hypothesis that trained simulated patients can be considered as assessors. Their future inclusion offers candidates a dual perspective (clinical and non-clinical) on performance, and saves clinical time.Discussion Simulated patients scored consistently and value can be added by including different perspectives in interactive assessment. Robust training is needed in all assessor training. CONCLUSION: Simulated patients can usefully contribute to scoring in national dental recruitment centres. Lessons learned here can inform other dental assessments where stakeholders are already using, or considering using, simulated patients as assessors or co-assessors.

Short stay emergency admissions to a West Midlands NHS Trust: a longitudinal descriptive study, 2002 2005.

OBJECTIVES: To describe changes and characteristics in emergency admissions to a West Midlands National Health Service Trust, 2002-2005, with a focus on short stay emergency admissions. METHODS: A longitudinal descriptive study using retrospective analysis of routine admissions data. Admissions were categorised as short (0/1 day) or long (>or=2 days) and examined separately using a General Linear Model. Factors favouring short stays as opposed to long stays were examined using multivariable logistic regression. RESULTS: There were 151 478 emergency admissions to the Trust between 1 April 2002 and 31 December 2005, of which 2910 (1.92%) had no discharge date recorded. Adjusted means showed a 7.76% increase in emergency admissions in winter months (October-January) and a 14.50% increase across the study period. Increases were greater in short stay (34.03%) than long stay emergency admissions (8.38%). Odds of short stays in admitted patients increased by 25%. Higher odds of short stays were also associated with younger age, winter month and medical admitting specialty (p<0.001). CONCLUSIONS: Increases in emergency admissions were greater in short stay than long stay cases. Reasons for this may be both appropriate (increased use of clinical protocols and falling average length of stay) and detrimental (pressure to meet 4 h emergency department target, changing primary care provision). Further research is needed before generalising findings to other Trusts.

Evaluation by dental students of a communication skills course using professional role-players in a UK school of dentistry.

This paper reports student (n = 180) feedback on the role-play teaching methodology used in behavioural sciences teaching at The School of Dentistry in Birmingham (UK). The feedback received on this well-established (since 1995) educational programme was collected via questionnaire (100% response rate), requiring Likert scale and free text responses. Generally students reported that they had enjoyed and valued the session. Over two-thirds (69.7%) of students rated the role-players as 'very real' and over three-quarters (78.9%) rated their feedback as 'very fair'. The data collected from this study will inform future curriculum development. Student feedback was very positive and demonstrated that the cohort (86% of all students studying in years 1, 2 and 3) found the use of professional role-players involved in behavioural sciences teaching to be both acceptable and valuable.